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Abstract

PARTIAL FISTULOTOMY WITH KSHARA SUTRA LIGATION IN HIGH ANAL FISTULA IN ANO- A CASE REPORT

Yogeshkumar Meghani and Vivekanand Kullolli*

ABSTRACT

Fistula in ano popularity known as Bhagandara in Ayurvedic classics occurs if Bhagandara pidika is not treated in proper time. About more than 90% fistula-in-ano develops due to cryptoglandular infection and rest of the 10% fistula-in-ano develops due to non-cryptoglandular causes like ulcerative colitis, post haemorrhoidectomy, sclerotherapy crohn’s disease, colloid carcinoma of rectum, lymphogranuloma venerum, actinomycosis, pulmonary tuberculosis, and other abdominal conditions those produce pelvi–rectal type of abscess.[1] New techniques like Fibrin glue injection, Fistula plug, Endorectal advancement flap, LIFT Technique (ligation of intersphincteric fistula tract), VAAFT (Video Assisted Anal fistula treatment), and PERFACT (proximal superficial cauterization, emptying regularly fistula tracts and curettage of tracts) are available for the management of fistula in ano. High anal fistula in ano is a frequently encountered problem in surgical practice, surgical management of which may produce a complication of incontinence and it takes long time to heal. The issue of treatment of high anal fistula in ano by kshara sutra therapy is one of the major areas of research and has come under increased study. Acharya Sushruta has given Chhedan karma in the management of Bhagandara.[2] He also mentioned kshara sutra chikitsa for Bhagandara.[3] In this study, partial fistulotomy with kshara sutra ligation was done for the management of high anal fistula in ano.

Keywords: Bhagandara, fistula in ano, fistulotomy, kshara sutra, high anal fistula.


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